Training and supervision of physical health professionals to implement mental health care in paediatric epilepsy clinics.

Cognitive-behaviour therapy Epilepsy Mental health Paediatric Teletherapy

Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
22 Jun 2024
Historique:
received: 29 01 2024
revised: 03 06 2024
accepted: 13 06 2024
medline: 24 6 2024
pubmed: 24 6 2024
entrez: 23 6 2024
Statut: aheadofprint

Résumé

Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments. This study aimed to train and provide supervision for health professionals to deliver a modular cognitive-behavioural intervention for common mental health problems, optimised for use in paediatric epilepsy. Specifically, this study aimed to measure therapist competence and evaluate the acceptability of training and supervision. Fifteen health professionals working in paediatric epilepsy services were trained over a six-month period. Training included face-to-face training workshops and completing at least one training case of a young person with epilepsy and anxiety, depression and/or behavioural problems under close clinical supervision. Throughout the training, health professionals were offered weekly one-hour supervisions with an experienced Clinical Psychologist. Clinical competence was assessed using a widely used measure of therapist competence in cognitive-behavioural therapy. Rates of attendance at supervision sessions and therapist ratings of satisfaction were recorded. At the end of the six-month training, 14 health professionals reached clinical competence in delivering the mental health intervention. One person left the service and therefore did not complete the training. Overall, health professionals were satisfied with the training and supervision. However, 14 % of supervision sessions were cancelled and a further 11 % were not attended. Supervision sessions were also often shorter than the standard hour used in mental health settings (M = 41.18 min, SD = 10.30). Our findings suggest that health professionals working in paediatric epilepsy services can be trained to deliver a psychological intervention with proficiency. However, the supervision model typically used in mental health may need adaptation to be sustainable in physical health settings. Future research is needed to evaluate the impact of training and supervision on patient outcomes and to ensure that ethical delivery of psychological interventions by health professionals without a mental health background.

Sections du résumé

BACKGROUND BACKGROUND
Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments. This study aimed to train and provide supervision for health professionals to deliver a modular cognitive-behavioural intervention for common mental health problems, optimised for use in paediatric epilepsy. Specifically, this study aimed to measure therapist competence and evaluate the acceptability of training and supervision.
METHODS METHODS
Fifteen health professionals working in paediatric epilepsy services were trained over a six-month period. Training included face-to-face training workshops and completing at least one training case of a young person with epilepsy and anxiety, depression and/or behavioural problems under close clinical supervision. Throughout the training, health professionals were offered weekly one-hour supervisions with an experienced Clinical Psychologist. Clinical competence was assessed using a widely used measure of therapist competence in cognitive-behavioural therapy. Rates of attendance at supervision sessions and therapist ratings of satisfaction were recorded.
RESULTS RESULTS
At the end of the six-month training, 14 health professionals reached clinical competence in delivering the mental health intervention. One person left the service and therefore did not complete the training. Overall, health professionals were satisfied with the training and supervision. However, 14 % of supervision sessions were cancelled and a further 11 % were not attended. Supervision sessions were also often shorter than the standard hour used in mental health settings (M = 41.18 min, SD = 10.30).
CONCLUSIONS CONCLUSIONS
Our findings suggest that health professionals working in paediatric epilepsy services can be trained to deliver a psychological intervention with proficiency. However, the supervision model typically used in mental health may need adaptation to be sustainable in physical health settings. Future research is needed to evaluate the impact of training and supervision on patient outcomes and to ensure that ethical delivery of psychological interventions by health professionals without a mental health background.

Identifiants

DOI: 10.1016/j.yebeh.2024.109905 PMID: 38909460
pubmed: 38909460
pii: S1525-5050(24)00286-5
doi: 10.1016/j.yebeh.2024.109905
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

109905

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Chorpita is a co-founder and member of PracticeWise, LLC, which owns the MATCH-ADTC protocol on which the MICE program is based. PracticeWise was paid for training and consulting including provision of supervision of supervision by Dr Stanick to ensure integrity of treatment implementation. Dr Chorpita and Dr Stanick did not interact with study therapists or participants, and were not involved in the analysis.

Auteurs

Anna E Coughtrey (AE)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: anna.coughtrey.10@ucl.ac.uk.

Sophie D Bennett (SD)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Cameo Stanick (C)

Sycamores-Hathaway Centre for Excellence, Los Angeles, CA, USA; UCLA Los Angeles, CA, USA.

Bruce Chorpita (B)

UCLA Los Angeles, CA, USA.

Emma Dalrymple (E)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.

Peter Fonagy (P)

Division of Psychology & Language Sciences, University College London, London, UK.

J Helen Cross (J)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.

Tamsin Ford (T)

Department of Psychiatry, Cambridge University, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.

Isobel Heyman (I)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK; Department of Psychiatry, Cambridge University, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.

Rona Moss-Morris (R)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Roz Shafran (R)

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.

Classifications MeSH